Thursday, February 26, 2009

Restored and Made Strong

This past Monday, February 23, is the kind of day that you never want to endure. Before Mom arrived at the hospital a new team of doctors with fresh perspectives, following old clues and conferring with the previous Critical Care Team were in checking and evaluating Dad. The ICU has a rotating team of medical professionals each week. Dad was scheduled for a new dialysis port for the morning, with dialysis in the afternoon. With doctors continually reviewing the charts you would think they would have been able to fine tune the trouble spot for Dad's mysterious infection and fluid retention that made his belly so distended. The doctors had an answer and a probable cause but the outlook did not look favorable for a full recovery for Dad. They suspected a rupture or leak of the chyle duct. I had never heard of this anatomical term. I guess it would be left to Google. http://emedicine.medscape.com/article/190025-overview.
Their explanation made sense, that's all that mattered. They would continue to do everything they could to try and turn around Dad's condition for as long as we desired. They were on morning rounds and I felt Mom needed to be present before any further treatment plans were engaged. As she arrived Dr. Cox and his team were prepping to put the new temporary port into Dad's neck area.

As they performed the port procedure, we took a walk to the lobby to mail some greeting cards Mom had prepared, one for Dr. Pates who delivered me 46 years ago. He is the oldest practicing doctor in Idaho! No, I wasn't born in Idaho. He used to live in Belding. His daughter was celebrating his 85th birthday with a surprise. We wandered back to the family lounge where Mom read her book and I wrote a little bit into the blog. Nurse Jenn came and said they were all set and we could come back anytime. Mom headed back as I packed up the laptop. She was gone a couple of minutes then peeked over my shoulder and said the doctors were done for their morning procedures and could talk with us in the consultation room.

They explained in greater detail of the possible chyle leak, which in healthy patients can be controlled. In order to confirm the diagnosis more tests, ultra sounds, and ex-rays of specific detailed areas would need to be done. Surgery would be required, which Dad was not a sound candidate for, considering all of the recent set-backs. The doctor explained in certain pro-active(politically correct?) terms that he was pro-life and respected the patient and the family's desire for protecting the quality of life. It makes one wonder what kind of college and humanity courses on compassion these professionals need to acquire in order to maintain their composure in such conversations with a patient's family. They needed to know if we had any previous conversations with Dad prior to surgery regarding long term, life sustaining measures. Any that knew Dad would question that we had already pushed the limits on heroic measures with all that had already been done. Dad had already been going to dialysis 3 times/week for a few weeks prior to surgery so was already in gear for that plan. With all of Dad's recent complications, at best, if treatment was in the Lord's favor, we would be looking at a long term stay in a Nursing Home. Prior to this last infection Mom and I were prepared to inlist the services of Spectrum Health's LTACH
http://www.spectrum-health.org/cs/Satellite?c=eHA_Content_C&cid=1218817408142&ehapubname=Cont_Care&pagename=Cont_Care%2FCont_Care_Central_Template
for rehabilitation to get Dad back on his feet and in his OWN bed. Nursing Home? Ventilator Dependent? With Dad no longer responding to us, the doctors or physical therapists how much more could we make him endure? We had already felt we overstepped heroic measures with the respirator following his seizure on January 28. With a tearful, prayer of petition to God, we felt his answer had been in front of us already. Dad had been breathing on his own, yet needed the extra pressure support of the ventilator to complete his breaths. As the infection increased so did the dependency on the ventilator. Mom and I agreed that if God was calling, Dad should have the dignity to heed his call. We tearfully called my family together. Pastor Curtis from Spectrum's Pastoral Care brought us a Comfort Quilt, hand stitched by the Quilters Guild at Emmanual Lutheran, and prayed with us as we laid it over Dad's feet. Dave's sister Mary and daughter Christine arrived to join us in our time of prayer and grief. We are one in body as a family. We surrounded Dad with clinched hands, hugs, prayers, tears and laughter from 3:00-4:45pm, at which time God peacefully called him home.

And the God of all grace, who called you to his eternal glory in Christ, after you have suffered a little while, will himself restore you and make you strong, firm and steadfast. 1 Peter 5:10

The hospital staff was generous with their compassion with regards to Comfort Care, making sure Dad and his family were comfortable and allowing privacy in our time of grief. His nurses Jenn and Bridgett monitored him quietly from their station, periodically coming in to make sure he was in a restful position.

Mary and Christine offered to drive our second car home, but Courtney said she was able. Dave and Courtney had picked Kelsey up at school so her friend Christopher had driven her car to his house, then later shuttled it home when the girls arrived. I drove Mom home in her Tahoe and Dave followed in our Expedition. She insisted that I stay at home with our girls. I didn't give her the option, I called my cousin Jim to come over. She said he didn't have to stay. We had already made a private decision that he would! He told her to get some sleep and he and Murphy would do their thing.

I felt sick to my stomach and had a horrible headache all the way home. Dave stopped at Walgreen's to get cold meds for him. I got out of the truck just to get air. Dave had made several phone calls to people while at Mom's. I wanted to make a couple more when I got home and spend some quiet time with my family, but all I could do was grab a bucket and curl up in my bed. With every twinge of pain from my pounding headache and the chill that overtook me, I was awash with grief and emotion. I could not help but think what kind of pain or the feeling of being cold my dad must have had at times while he lay in that bed unable to talk. My only comfort was knowing that Dad was no longer in pain. I realized I was about 10 hours past due in taking my blood pressure and anti-anxiety meds. I don't carry them with me. Courtney brought me water and Dave garnered my pillow, which I had left in the living room on Sunday afternoon, and another comforter because I was so cold. I finally fell asleep. I awoke at 12:04am feeling much better. I checked on my sleeping girls, let the dogs out briefly and went back to bed. I don't even remember if Dave snored ;) I did wake up every couple of hours though.

Tuesday, February 24, 2009

Tribute and Honor Arrangements

Johnson-Feuerstein Funeral Home
203 S. Pleasant St.
Belding, MI 48809
616-794-1630
toll free: 1-888-663-5633

http://www.jffh.com/
Funeral services will be at 10:30am, Thursday
at Johnson-Feuerstein Funeral Home
in Belding with Pastor Kendall Harger
of Shiloh Community Church officiating.

Interment with full military honors by the
Belding VFW Post 4406
will follow in River Ridge Cemetery.

Visitation will be Wednesday from 6-8pm at the funeral home.

Memorial contributions may be given to the Alvah N. Belding Library


Farewell to a Great Man

Monday, February 23, 2009: With heavy hearts we said an earthly farewell to our dad, husband and grandfather today. With all of us surrounding him in prayer, Dad courageously entered the woods of Heaven with Our God and Master of Creation at 4:45pm, from the Fred and Lena Meijer Heart Center.

Please uplift our family in prayer for peace of mind, as we struggle with Dad enduring 3 weeks of treatments and now as we open a new chapter in our life.

Thank you to all who have been a link in our chain. We are ever grateful for your thoughts and prayers.

I will post further information regarding services later today.

For to me, to live is Christ and to die is gain. Philppians 1:21

Monday, February 23, 2009

Sunday, February 22: Ex-ray was in at 6:15am. Dad was restless this morning and his blood pressure is up and down. Nurse Holly laughed and said Dad's morning meds look like pea soup. I agree...ewww! She mixed meds and benefiber and uses a huge syringe to plunge it through his feeding tube.



Physical Therapy came in early and had to deflate Dad's air bed in order to turn him and get him to the edge of the bed to sit up. The right corner of Dad's right eye is really blood shot and his left eye has a yellow film over it. I asked the doctors about it and they said the right eye was probably caused from a broken blood vessel due to coughing and the left eye was just residual blood. Neither should cause alarm. They still look nasty. Mom arrived about 9:00am. I skipped church because the doctors came into talk to us right when I would have needed to leave. I cut for home about 10:30am. Gwen Petrowski pre-arranged to cover my Sunday School class this morning. Thank you Gwen!



Dad received a unit of blood today. He had another Paracentesis performed with another 5 1/2 liters removed! Arrghh!!! Dad was snoozing soundly after the procedure so Mom called and said she was coming to visit. I was excited because for once I could treat her to a meal. I had put a roast in when I got home then I took a long nap. Courtney added carrots when she got home around 1:00pm. I was just starting to make noodles when Mom called. She loves beef and noodles, so it is a good day. Mom headed back to the hospital about 6:00pm. Nurse Sue and Tech Christopher started their shift by removing Dad's temporary dialysis port. The doctors don't like to leave them in for a long duration as infection can occur. A new one will be placed on Monday before dialysis.



Mom creeped out a little after 9:00pm. Family acitivities kept me busy at home so I didn't get up to the hospital until after 10:00pm. I called Mom and when I walked back to the room Sue and Chris had the door closed. I checked with the desk supervisor and she called Chad, who was in the monitor room. They were shaving him and hadn't started his bath yet. I knocked and snagged my bag with Dave's laptop so I could chat with Kelsey and Courtney for a few minutes before bedtime. Dad was awake on and off through the night. Sue sat and visited for a few minutes during a break. She peeked in to say she leaving for lunch. Dad was getting kind of restless. I had his right wrist restraint off which is near his respirator tubes. He rested his hand on his forhead and rubbed his fingers across his eyes. I asked if he had a headache and he winced. Sue arranged for some Fentanyl and Nurse John came in to give that dose. I hate seeing Dad in a fog but really don't want him in pain either. It is better for him to rest at night so he is more alert for all of the crew in the daytime and for Mom.

Sunday, February 22, 2009

Nahma Nurse


Saturday, February 21: Dad was restless this morning and Nurse Holly gave him a dose of Ativan while I why dozing. His blood pressure dropped lower than should be for going into dialysis in a short while and he was very lethargic. Holly suctioned him which usually wakes him up and brings up his blood pressure. What a way to wake up...bah! Jim McMillan called just as Mom was walking in Dad's room. He really wants to be able to help Cindy with Murphy when he can. He reminded me that he has a ramp for Murphy :) Mom said that Sally B called and was only 4 hours to her sister's house and it was 75*.

Nurse John started dialysis a 9:30am. He is such a hoot to carry on conversation with. He and Patty are so good at running Dad's dialysis. We are always happy when they are scheduled! Physical Therapy popped in toward the end of dialysis but was not able to work with Dad today due to his schedule. I went for home to spend some quality time cleaning and hanging out with my family. Once again I tried napping to no avail. John was finished about 2:15pm and had taken a 1/2 liter of fluid off. Shortly after John left, Dad's blood pressure monitor set to beeping. His bp was 193/113! He had not had bp meds due to dialysis and Nurse Holly was at lunch. The nurse covering called and was able to administer his bp meds. Within 20 minutes his bp was in line where it needed to be.

Dave is trying to get rid of his cold so he hit the bed for a nap. Despite the snowstorm that has finally arrived, I took Courtney & Kelesy to Alpine for a beauty supplies run to the Meijer Outlet, Marshall's and Ulta. Everybody contain your excitement...lol. Mom called just before 7:00pm and was going to leave for home because the weather wasn't getting any better and Dad was resting. Dave was lounging on the couch in front of the TV when we got home. Kelsey had already called Chris Mulder and he arrived to watch Nascar and hang out until Liz was done with work. Liz had got to our house shortly after I left for the hospital. When I called Mom at 9:30pm she said the roads were horrible, especially near Paulson's house. An oncoming car swerved right into her lane. She was able to tap her breaks and stop and put her Tahoe into low gear. I told her Dad's blood pressure was a little low and I hadn't talked with the nurse yet. Courtney went to a birthday celebration at friends at Calvin College. She made arrangements to stay over with her friend Courtney M and go to church with her in the morning.

When I got back to Dad's room I chatted with Nurse Suzanne, answering questions as to when and how long Dad has been enduring cancer treatments. Dad's bp balanced out. Our conversation led me to comment that Mom and Dad had gone to their home in the U.P. for few weeks after Dad had his drainage tube of 9 months removed in September. She exclaimed, "I lived in the U.P. for 15 years!" Interesting...I asked where. She said between Escanaba and Manistique! I told her our northwoods home was in Nahma. She laughed and said she and her husband and kids had moved two years ago from Nahma Junction! Oh, my word! That is literally a few miles from our house.
She grew up in Milwaukee and her husband grew up in Cooks. Her father-in-law, Harold Carly is 92 years old and still lives there. The Disney melody comes to mind...'It's a small world after all!'

Dad spiked a fever again about 1:00am. More meds to control that and more questions as to where is it coming from?! He has had a couple a really good days with no fever.

Floating on a Bed of Air

Friday, February 20: The Thursday overnight guard was mostly uneventful. Dad had a fairly tiring day on Thursday, and I hadn't been able to sleep at home so I was able to close my eyes a little easier in the super recliner.


Nurse Patty was in shortly after the ex-ray crew, ready to rock Dad's morning with dialysis. He had a really good run this morning and Patty had few issues with the machine. Mom arrived at 10:30am and he only had 30 minutes left of his dialysis! She said that Ken had called to check on Dad. She made an early stop at Leppink's Supermarket to pick up hot dogs, bologna, and turkey...for MURPHY! I left about 11:00am for errands before heading for home. The docs came in right after I left. They told Mom everything is looking good but it still will be a long road.

Mom's friend Sally S surprised Mom again about 12n. They went down to the cafe for sundaes while the Physical Therapy team worked with Dad. Sally visited with Mom until 4:00pm. Its refreshing for Mom to have someone else to talk to. Nurse April and Tech Emily got Dad cleaned up after working so hard with PT. Dad was very active today. When Mom told Dad, "I love you," he smiled and winked at Mom. When he is alert he has pretty good control of his eye contact.
Mom said there was a Kin Air Bed waiting to be moved into his room later.


Dave is whipped from the cold that he has procured. I wonder who he picked that up from? Its surprising he wasn't sick earlier than now. Despite him feeling like he just got hit by a Mac truck, he changed the wheel and tire on Kelsey's car. He had called me earlier to make a phone call and order a wheel from Bakers. He had picked up a used tire from Schneiders in Marne. Kelsey had a chunk out of her wheel and it went into the sidewall of the tire. Somehow supper hour and sleep seem like a perfect match. I think my whole family napped at some point during the early evening hours. I remember waking up hearing Kelsey and her friends talking. I was still tired. Dave told me he had taken care of the beef ribs that I had set to cooking earlier. Mom called and was leaving soom after 9:00pm. By the time I got my body into gear, I didn't get to the hospital until 11:30pm. Nurse Kara and the tech were getting ready to give Dad his bath and transfer him to his new air bed. It was a team effort by a few staff members.


His bed looks like a giant pool float set down into a hospital bed frame. It is inflated based on his height and weight. He seems to be able to rest more comfortably now.

Thursday, February 19, 2009

Strength and Reassurance


Last night Dad was supposed to have Kris, whom we have never had, for his nurse but the gentleman next door required her undivided attention. He has more monitors than a pop-star. I think he was deserving of her TLC. I had arrived just as they were preparing to give Dad a bath and get him boosted in a new position for a couple of hours. I chilled in the waiting area calling Mom, per her order, and texting Courtney & Kelsey goodnight ILY's. When I was able to chat with the nurse I thought it was Dan, but he introduced himself as Justin, Floor Supervisor. Charge Nurse Dan was attending Dad before Mom left, but he was called to assist in another room also. Justin is another outstanding nurse. He was attentive to every beep and bonk on Dad's monitors. He has definitely earned his stripes as a Floor Supervisor! Kris was covering for Justin during lunch and also was top-notch at making sure Dad was comfortable.

I commented how nice it was to see so many male nurses. Justin told me there is a higher ratio of male nurses in Critical Care. Kelsey has a couple of guy friends going into Nursing. My advice for you: Go rock the world with this awesome desire that God gave you!!!

Although Dad was resting comfortably, I could not fall asleep. As I watched out the window looking to the East up Michigan Street all I could see was some slight dusting of snow. The forecasted snowstorm had passed us by. My eyes finally drifted shut about 4:00am. Dad began stirring around 4:30am! I did nod off but was awake when ex-ray arrived at 6:15am, then wandered to the family lounge. Someone's support crew was trying to find respite in a couple of chairs pushed together. Both TVs were blaring, cartoons on one and news on the other. I saw school closings listed for the lakeshore cities so I know it was snowing somewhere! I turned both TVs off. Despite the lights at least she was minus the noise. Kelsey told me last night to call at 7:00am not 6:45am. I saw 6:45am come, but dozed until 7:10am...oops. I'm just her kick, in case she hits the snooze button which she rarely does. She was moving & ready to leave for school :)

At the changing of the guard, Nurse Rob resumed his daytime duties. Mom arrived just as the doctors came in to check on Dad's progress. They scheduled a paracentesis, poking the belly with a long needle, http://www.webmd.com/brain/paracentesis-17042 for later in the day. The Heparin drip was stopped. Dad was restless and moving quite a bit. Having a sore bottom would certainly make anyone want to be in a different position! The petite PT crew was in for another round with Dad. Considering the requirements for the job, you would totally expect a Physical Therapist to be tall, 200+ lbs, with a muscular build. I have never encountered a PT with that description. They have all been small framed, with muscles from nowhere. When I look at them I think of a gymnast :) They have been great at working with Dad. They came in and worked with him 2 different times today. Each time they are increasing the time frame they will work with him. They also suggested they will look into a 'stretcher chair' to help Dad get more mobile.

During the belly tap this afternoon, they drained off 5 1/2 liters of fluid equal to 12 lbs! Mom and I thought they were just drawing off enough, like a syringe full, in order to culture it. That is like carrying around 24 cups of coffee!!! Where's the bathroom, already? Mom said he rested nicely after he returned from Radiology. I think we all would!

I always ask Mom if we can bring her some lunch or dinner from home. She is content to find something from the cafeteria that she enjoys. After her oatmeal in the morning, she is actually a fairly light eater. We savored our lasagna dinner, garlic bread, salad, homemade applesauce and cookies. I brought Mom some of the cookies for her snack tomorrow.

Kelsey and I went to Jenison to show respect to Vern, Jana, Brianna & Kaylee VanHalm, in the passing of Vern's father. On February 15, 2009, at the age of 76, Tunis Henry VanHalm joined His Heavenly Choir. May God bless your family with His sustaining grace. Jana said she had talked to her friend Gigi, who had been Dad's nurse... ??? I felt dumbfounded, then she told me her formal name was Gabriella. I reassured Jana that she was an awesome nurse! We have really been blessed with some terrific care givers here.

When I talked to Mom around 7pm, she said if Dad settled down she would leave for home before I got to the hospital. Mom called Courtney to say Jaci is Dad's nurse and is taking good care of him so she left about 9:15pm. I dropped anchor at 10:15pm. hmm...I wonder if she got Murphy's golden arches burger? I forgot to ask :)

There were 3 doctors checking in with Dad from his paracentesis today. We discussed some details. There is the possibility the excess fluid could be caused from recurring cancer, since that has been an ongoing issue, or from liver failure, or something all together different. It is definite that Dad will not be undergoing any surgery anytime soon. He is still very weak and his prognosis for full recovery is not looking in his favor. When test results do not show difinitive answers, a time will come when we need to honor Dad and give him the dignity he would desire.

It breaks my heart to not be able to have a two sided chat during the midnight hour. Dad and I have had the 'farewell' chat many times before. He has been a cancer survivor for 9 years! Being in ICU reminds us daily of 'sudden good-byes' without a farewell. Being an only child, my Mom and Dad have rocked my world with love for over 46 years! I am frustrated that our household has been a recurring petri dish of colds and sniffles, or worse. We have not spent as much time as a family with Dad in the past year because of his high susceptibility for infection. Although, we talked frequently on the telephone, sometimes about nothing and other times we were surely going to save the world! Our girls are 19 & 16 and we have never had a full family photo taken. I go back to my 3rd grade Sunday School lessons, through our prayers of petition we need to take time to listen and hear God's answer.

A greeting card from Mom's cousin Wanda inspired these words:
We are reminded that God who created us can put our world together again.
We ask Him to bring us strength and reassurance as we lean on Him and rest.

McDonald's Coffee Club Missing Louie

Wednesday, February 18: Before Mom left for the hospital Dennis Daller brought her a card for Dad that all of Dad's friends from the McDonald's coffee club had signed. She stopped at Meijer and bought a dry erase board that Dad can use with better ease if he feels like writing.

PT arrived spunky as ever at 8:30am, to get Dad up and active. Patty the Dialysis Nurse peeked in and giggled as she saw the girls working with Dad. The PT's smiled and said, "We wanted to get in here and work with him before you tired him out with dialysis!" Those girls had him sitting up for 18 minutes! Thats about how long you would sit before you went and got a hot refill on your coffee! The PT's worked his legs and arms for a few minutes then let Patti at him with dialysis. Nurse Rob is awesome! He voiced his concern with the doctors about the breakdown of the skin around Dad's trach and his excoriated backside. Unfortunately, from being in bed for so long he has developed sores :( He gets slathered with SensaCare regularly. It is great to have male nurses because they can 'feel Dad's pain'! Since the doctors haven't identified any bacteria that requires Vancomycin, that is being stopped. He is still receiving other anitbioctics.

I returned Linda Alkema's call this morning to catch her up. Her husband Brad has also been sick and she has pneumonia! She said they along with JR and Carol Rosendal were bringing us supper on Thursday. She wanted to find out what night we were all home for dinner. I didn't think I was really all that tired but I slept a good share of the day away. I talked to Carol late this afternoon. I have been going to make homemade chicken noodle soup for a couple of days, but haven't made it to the store to get chicken. For once I don't have any in the freezer! I created enchiladas with some leftover roast and ground beef. Kelsey went straight to church from POMS and ate chicken fingers. Courtney ate with Dave and I before leaving for Club 56. She had to go to the medical library downtown afterward, then went to Ballroom Dancing at Calvin College. I called Mom around 9:00pm to tell her I had not even showered yet. She called back a short time later and told Kelsey they were washing Grandpa up and she was heading for home. Kelsey and I went to Meijer and spent $140.00 on groceries and still didn't get chicken! Hey, it was not on my kind of sale. I'll get it at Sam's. Kelsey is getting her lessons in this week. She had to wash her own gym clothes without me last night because I hadn't washed the load they were hiding in. Tonight she was counting the FREE items we were getting and guessed we had about $135.00 in groceries. I didn't get to the hospital until almost 11:30pm. Mom had been home for almost an hour. Mom has been boosting McDonald's bottom line keeping Murphy in cheeseburgers! Tonight the arches across from the hospital had a big line so she snuck thru on the Beltline just before closing.

As iron sharpens iron, so one man sharpens another. Proverbs 27:17

Vertical & Ready to Cruise with the PT's

Monday, February 16: Kelsey has Winter break so no school today. Dad's steak and eggs slurpie was stopped this morning for procedures later today. Physical Therapy came in and had Dad sitting on the edge of his bed! He let out of a couple of really good belches. That had to feel good! Of course he was woozy from being vertical and from having Xanax 2 hours earlier. They had him wiggle his toes, kick his feet out, and put his feet flat on the floor. I think he liked having his feet meet the floor! He was wobbly and gripping the rail of the bed himself, but he would sometimes close his eyes. He didn't seem ready to lay back down after 10 minutes, but the two petite PT's managed to settle him back into a comfortable position. Just as they were swinging his feet back into bed at 10:00am, in walks Mom. I told her she missed all the action :( She was excited that he had been able to sit up. It was great to see his blood pressure improve when they sat him up.

After I left at 11:00am, Radiology came in the room to do an Ultra Sound of his arm. He then went downstairs for a CT Scan. Nurse John started his dialysis this afternoon. He had a difficult time keeping Dad's blood pressure up. John is always ready with Albumin. His dialysis was done about 9:00pm.

Kelsey spent the afternoon at Amanda's until POMS practice. We met Kelsey after practice, at Steak 'N Shake in Grandville for supper. The youth group at our church was having a fund-raising event. Dave and I both agreed we liked a Wendy's burger better. We rarely eat at hamburger places. Kelsey had chicken. We would definitely enjoy a fund-raiser at Carlo's O'Kelley's Mexican Restaurant or Subway! Kelsey and friend Abby spent the night at Elizabeth's house.

When I got here John was still finishing up with the machines. Dad's BP leveled off. Dad was a busy man today so he is tired. They started him on a Heparin (blood thinner) drip for the clot in his arm.

Tuesday, February 17: I left about 10:00am. I got all the way to the ER parking ramp and realized I had left my phone in the closet. When I got back up to the room PT was in working with Dad again. He sat up on the edge of the bed for about 10 minutes. His Respiratory Tech Theresa, that had exclaimed last week that he was alert, was back from a few days off. She popped in as he was sitting up, "Wow, Louie, look at you!" PT continued to work his legs and arms once he was laying back down. Dad's Renal docs decided no dialysis today, but they are going to juice him up with 2 units of blood. The Ultra Sound from yesterday identified 3 clots in Dad's right arm and the doctors think this could be causing the fever. Honestly, Mom and I feel like we are on an episode of 'Mystery Diagnosis'! This is day 29 in the hospital, only 4 have not been in ICU!

Kelsey is still on Winter Break today so she went to RiverTown Crossings with her friends. She needed a nap at home before meeting back at school for team dinner.

When Radiology came in to do the TEE to Dad's heart, Mom came to our house and we soaked in the hot tub for a few minutes. She was gone for about an hour. The TEE went well and everything looked good. It was a simple dinner of spaghetti but it made Courtney happy. She was off to her evening class downtown then to Swing Dancing. Dave and I went to the Calvin game against Allendale. Kelsey danced in POMS tonight at half time. Kelsey was going to Rainbow Grill with friends and Dave was going home to meet the couch. I arrived for the night shift about 9:30pm. Mom called when she got home and said the roads were good until she hit M-44 and it was icy and was blowing sleet all the way to Belding. Courtney got here about 11:00pm, but Grampa was having his bath. We grabbed munchies from the closet and kept each other entertained in the family lounge until midnight. She was excited when we heard her friend John's name called over the intercom. She checked facebook and said, "Yep, he's working." He works in the lab. Once we got back into the room she stayed for about 30 more minutes. I told her she was looking tired and should go home. Dad was resting comfortably so I walked her out to her car. She dropped me back at the ER door.

Strengthen the feeble hands,
steady the knees that give way;
say to those with fearful hearts,
be strong, do not fear...Isaiah 35:3-4a

Tuesday, February 17, 2009

Surrounded by Friends

Sleep can do wonders for the body! Although I do sleep at night when I am at the hospital, if Dad is agitated, I don't. I relaxed with my family Friday night. Kelsey had a couple of friends over and we watched TV. I went back to bed about 1:30am(Sat) and didn't clamber out of bed until about 12:30pm.

Mom walks Murphy each morning before she leaves. Since he is an older dog its like having a puppy again ☺ She walks him at night when she gets home and usually one or two times during the night. She says she doesn't dare roll over because he sleeps on the floor next to the couch and he will think its time for a walk. Sally Buckley has been driving in and walking and feeding him throughout the day. Sometimes my cousin Jim spends time with him and Mom and Dad's neighbor, Cindy takes care of him. Cindy is also caring for her 33 year old daughter Beth, who lives with them. Beth endures frequent seizures throughout the day. Both of Cindy's daughters are cancer survivors. Murphy has lots of people loving on him but he still likes his Mom and Dad best!

Although we are really not sure how much Dad is able to focus with his eyes he will track his eyes with our voice and face. On Saturday morning, Febuary 14, when my cousin Roger and friend Ed said goodbye to Dad, they held his hand and Dad grinned ear to ear as if contented that they stayed with him. Sally B was visiting with granddaughter Deanna today so its Cindy at the helm with Murphy. Ken Haverstick called Mom to check in for their gang in Florida. Today Dad had a CT Scan, he shook and shivered through 4 hours of dialysis, and endured another ultra sound. Mom's friend Sally Shurlow came down and spent 5 hours with her. The PA(Physician's Assistant) told Mom everything looks good, other than the source of infection... He said Dad will continue to receive Ativan. Mom held up a paper tablet near Dad's face and he held a pencil and slowly drew a small flower and wrote H B. Dad always gives Mom a rose on Valentine's Day and signs all his notes with H B, which stands for Honey Bear! A small stroke forward.

I arrived at 9pm to relieve Mom. She called when she got home to tell me Cindy got the prize. Murphy slipped & fell in his business and Cindy cleaned him up with paper toweling :P She is such a trooper! Mom washed him spiffy clean with sudsy water when she got home.

February 15: I left just before Mom arrived so I could head out to church. I related very well to Pastor Craig's message this morning. The verses from Galatians 2:17-21 and Philippians 1:19-24 were pivotal for our current walk. After the contemporary service I am a 2nd/3rd grade Sunday School leader with 3 other small group leaders and 2 large group leaders. We are discussing 'prayer' and how to talk to God and how to listen for God's answer.

Dave and Courtney went home after church service. When Kelsey and I got home from Sunday School, Dave was in sweat pants and sweat shirt under the down blanket in bed. Not good! He is now getting what the rest of us had...yuck!

Dad's temp was up most of the day. They still are trying to pinpoint the source for the raised white blood count. He was relaxed for most of the day. Mom took a brief break and went to Menard's. When I arrived at 9:15pm, she showed me that people really do buy snacks there. She had replenished our bag of munchies with chocolaty confections :D Murphy was so excited when Mom brought the Menard's bag in. He thought he was getting burgies! Mom felt bad because the McDonald's in Belding was already closed and she couldn't buy her boy a cheeseburger :(

...serve one another in love...love your neighbor as yourself Galatians 5:13,14

Friday, February 13, 2009

Balance

There is a time for everything,
and a season for every activity under heaven:
a time to be born and a time to die,
a time to plant and a time to uproot,
a time to kill and a time to heal,
a time to tear down and a time to build,
a time to weep and a time to laugh,
a time to mourn and a time to dance,
a time to scatter stones and a time to gather them,
a time to embrace and a time to refrain,
a time to search and a time to give up,
a time to keep and a time to throw away,
a time to tear and a time to mend,
a time to be silent and a time to speak,
a time to love and a time to hate,
a time for war and a time for peace.
What does the worker gain from his toil? Ecclesiastes 3:1-9

I captured the photo in the Fred & Lena Meijer Heart Center lobby.

Thursday night was an extremely difficult night for me. I made no attempt to even rest my eyes. Dad was aggressively agitated. I don't desire for him to be sedated, but asked if there was anything they could give him to help him rest. The Tylenol and Motrin didn't even seem to phase him. I felt terrible watching his frustration. He wants to speak, but is unable. I had to gather my strength by leaving the room once the nurse and respiratory tech arrived. They called him Houdini. His strength could overtake me. I called Mom at 5:45am. She quickly walked Murphy and left for the hospital. I then called Dave and he woke Courtney and Kelsey up to bring them to see their Grandpa. Ex-ray arrived along with doctors doing rounds. Dad's hemoglobin was deemed deficient from an earlier draw. As Mom, Dave and the girls arrived the nurse started a blood pack. Dr. Fitch came in and checked Dad, talked to him asking him lots of questions, then explained the plan for the day. He would have a new temporary dialysis port placed on the left side of his neck.

Dave delivered Kelsey to school a little late. Mom insisted she would be fine and wanted Courtney and I to go home and rest. We made a quick stop at Sam's to pick up meds for Courtney. I was physically and emotionally drained! I was in bed by 9:45am. I woke for brief moments throughout the afternoon, but did not get out of bed until Mom called about 5:30pm. My head was pounding. Mom said they gave Dad Ativan to help him relax after his procedure which went well. I am aware of this med because it has been given to Kelsey in the ER a couple of times. I am staying home tonight. Mom is going home while my cousin Roger and his good friend Ed, both hunting buddies of Dad, will stay at the hospital.
Dad's nurse told Mom the staff is able to care for Dad very efficiently without family present. Mom told her until Dad can push the Nurses' button on his own, someone will be with him.

I am having a difficult time balancing our predetermined plans for treatment when Dad is mentally alert, with his physical strength improving each day. His breathing continues to improve although he coughs sporadically, which requires him to be suctioned. The vent is only giving him minimal support when he needs it. He is obviously uncomfortable from the rash on his backside, which makes me cringe in pain for him. The doctor's have assured us they can have him sitting up soon as he is strong. The infection still continues to have control in his body though.

Although we have our own vigil in ICU with Dad, we are more than aware that we are in a sea of families floating with their own life-rings. Being in ICU, grief and emotion are present every moment of the day. This is a ship of close to 1,000 hospital beds. Although the skilled staff is there to serve their patients, I have not seen resort wear and little drinks with umbrellas. Its stethascopes, IVs, and white styrofoam cups of water.

We are blessed to share continued moments with Dad even though they are anxious filled at times. We know that Dad can overcome this trial, yet as I wrote previously, we can plan the future, but not the outcome. We have shared grief too many times recently with family and friends who have not been graced with the blessing of future plans with their loved one...

Alert and Agitated

Alert and agitated best describes Dad’s mood over the past couple of days. Fatigue and a slow hospital network got the best of me therefore there has not been an update until now…sorry. For my sister-in-law Mary, the short & simple version: Dad is alert and acknowledges us, agitated with his circumstances, fighting an unknown infection, still having complicated dialysis treatments and probably missing the History channel.

The specialist attempted to perform the TEE or transesophageal echo
http://www.heartsite.com/html/tee.html , on Tuesday, 2/10. He was unable to get the scope down the esophagus due to the balloon like inflation of the trach device, possibly due to the new trach http://en.wikipedia.org/wiki/Tracheotomy . The doctors still feel it is an important test to look at the heart valves, so they think they will attempt it again in a couple of days. Dad’s temp was down to 37.2* today. He was very alert all day. Mom held his hand and talked to him most of the day. She watched the Physical Therapist intently to know what exercises to help Dad with.


Courtney had class across the street at the GVSU/Cook Center so she stopped in to visit G’ma & G’pa for a few minutes on her way to Swing Dancing at the Grand Rapids Public Museum. My best friend Sandy had to come to GR so we arranged for her to meet me at the hospital. She was actually walking directly in front of me coming across the walkway! She won the ‘How Cold Can You Get?” contest. After about an hour, with a heavy sweater on, sitting with her left shoulder near the picturesque window overlooking the GVSU building she said her shoulder was throbbing. She told me the next day as soon as she got into her vehicle she turned the heat to high & flipped on her heated seats for the ride back to Belding! Dad was a little restless but as ICU nurse & friend Sandy suggested, try to interact with him as little as possible at night so he will sleep. With his alertness, I do not want to challenge him at night because he just gets agitated. You learn which beeps and bonks need stern attention. Earlier in the day I had called Courtney’s pulmonologist to ask if she could stop taking the Serevent diskus he had prescribed her 2 weeks earlier. Her heart had been racing ever since she started using it. Her last dose was in the morning, so he said not to use it at bedime. At about 1am I was chatting with her online and she said she couldn’t breathe. None of my bag of tricks seemed to work. It is a regular occurrence with Kelsey, but not Courtney! I called home to alert Dave and he had already heard her. I could hear her gasping in the background. He said he would call me back in a few. That was a long ‘few’! I was ready to head to St. Mary’s ER a couple of miles away, since that is where our new doctors are based. Not able to be the hands for her to hold during her ‘breathless’ attack, I sat here crying and praying until Dave called me back. She got back online and was feeling better so I stayed at the hospital. She went to bed knowing she can call me at any hour if she needs me. Even though the nursing care has mostly been excellent, there are times when Dad has coughing episodes or fidgets enough that he compromises his tubes and lines. Despite cameras & monitors, his nurse may be busy with another patient. He manages to maneuver himself how he wants to be even after they reposition him. Then he reaches for his tubes and he might be sleeping! Mostly, we are here so he knows we have not abandoned him. Nurse Jerri had a new admit that consumed much of her night but she still checked in on Dad, or arranged for another nurse to do so.

I was awake when ex-ray arrived at 6am. Sometimes I feel a thump and a heavier burden of weight. The techs will lay an ex-ray protection cape over me, which sends me stumbling out of the super recliner into the hallway. Dad finally began to rest after ex-ray left and I fell asleep somewhere after 7am. I felt something warm around my neck. I looked up and new nurse Maggie was tucking a warm blanket around me…sigh. I was already in a sweatshirt hoodie (hood on), wrapped in a polar fleece blanket and covered to my nose with a down blanket! It was around 8am. She said, “He’s resting, go back to sleep.” Mom arrived about 9:30am, after a foggy and very rainy drive. Nurse Gemma was just starting dialysis. She was brought up to speed with Dad’s case quickly, as his blood pressure will often spike, then bottom out. The proper amount of flushing and added dosage of Albumin is critical. She took 2.4 liters of fluid off. They needed to add 1 liter of fluid back in L .

When I got home Ruth Beyerlein had already dropped off everything for dinner. A large pan of chicken lasagna was thawing on the counter. She had brought a loaf of garlic bread and a whole cantaloupe. Then hiding under her instructions was a delectable brownie like dessert laden with chocolate & butterscotch chips, nuts and NO calories. Well, I’m not going to count them! Thank you so much!!! I slept hard from 1:30-4:20pm, got up and only had to turn the oven on and slide that pan in. I did cut up the melon, an easy and delicious task. Kelsey blew in from practice with the wind, snagged a ‘to go’ plate and left for youth group. She was singing so had to be there early. Dave, Courtney & I enjoyed dinner together. I laid down again for about 45 minutes, but couldn’t sleep. I had to pick up a few things from Meijer and called Mom to let her know I would be on my way but wouldn’t arrive until after 10pm. The nurse and tech were preparing to bathe Dad so she was going to head for home. She decided to try and sleep in Dad’s bed. Murphy did not approve. He kept coming in and looking at her. He prefers her sleeping on the couch next to his bed on the floor. Mom was able to do some housekeeping stuff at home before leaving.

This morning it was a lively place around here. Nurse Cindy came in and asked if I was ‘Mrs. Louie?” I was asked this once down on 7north also J. When I said I was his daughter she laughed and said when Mom arrived she would ask her if she was his daughter! She had two nursing students from GRCC doing their clinicals working with her today. Dad’s Respiratory Therapist also had a student from GRCC doing clinicals. Dad was very uncomfortable this morning. I had just got done talking to one of Dad’s doctors when his RT rushed out and exclaimed, “He’s alert, I mean really alert!” I said, “I know.” She wondered how long he had been like this. I told her three days! Apparently the doctors were just thinking we had ‘wishful thinking’ that he was coherent. Since he would be sleeping and wouldn’t react to them or he was being stubborn (NOT Louie…lol), they tell us his mental state is clouded due to the fluid, swelling, infection. We can agree with that but also know Dad is alert to his surroundings. One of Dad’s doctors was trying to determine if the dialysis port needed to be changed. They are thinking this might be the source of his unknown infection. They have identified the bacterium, but I forgot to write it down. It is one that can occur with dental break down also. I had informed the PA yesterday that Dad had his teeth cleaned 4 days before his surgery. Since it did not show up on other cultures, they are in the elimination process. We sure hope an exact source is found soon. Nurse Patti came in and got dialysis started. Dad’s blood pressure went up to 199/72! In true form it also dropped severely. With a call to the renal doctor, Patti stopped dialysis early. His critical care doctor was on the phone with radiology scheduling to have his port removed. He went down about 3:45pm. He is scheduled to have a new port placed on Friday. His next dialysis will not be until late Saturday.

After a simple supper with my family, Kelsey went to Poms practice, Courtney went to play for the MOPS dinner, then to the hospital to relieve G’ma. Dave saddled up with the dogs in front of the TV and I spent a fun 1 ½ hours with Halea, Sophia and Dillon filling in for Kelsey until she got done with practice. I even got to rock a sleepy Big D!

Dad’s night nurse doesn’t like him resting his leg up on the side of his bed. It effects the inflating action of his leg circulators. His previous nurses concluded he was going to put them there regardless of what they wanted, so they tried to make him more comfy the way he wants. Tonight he is really restless. Think of having the flu and only having one source of exit for all of the toxins. It is not all coming out in dialysis … I think that paints a ‘burning’ picture for you! Hopefully, the day ahead will bring us more affirming answers. We really hate the side effects of this infection. As mom wrote in her journal for Thursday…”Louie always says, You can plan for the future, but not the outcome.

”When you go through deep waters and great trouble I will be with you. When you go through rivers of difficulty, you will not drown! When you walk through the fire of oppression, you will not be burned up; the flames will not consume you. Isaiah 43.2

Tuesday, February 10, 2009

The Difference of a Day

The difference of a day; lots of changes...good changes! Eleven days ago it was the difference of a day. On Wednesday, January 28, we were ready for Dad to get out of the hospital the next day. That day came with a change of plans. We took a walk with God back to ICU, not sure what kind of change for Dad the next day would bring. Each day has been a challenge full of new information, but promising reports all along the way. Infections, defective appliances, fevers and coughs have consumed our moments. Dialysis, medications, ventilators, scans and ex-rays have filled our days. Nurses, techs, respiratory and dialysis specialists, and doctors from every field of play marvel our minds with information.

With our bible in hand and knees worn from prayer we give it all to God. His answer is not always clear. We lean strongly for more understanding. Yesterday was our first challenge. We were reminded we are not in control. Dad was very relaxed after the new trach went in Sunday night. I noticed an overwhelming odor upon entering his room. All the garbage cans were full so Nurse Elizabeth and I were not sure of the source at first. Since the trach surgery was performed right in his room, it could have been from any number of things. We soon realized it was coming from his trach. Pseudomonas and other bacteria are a common side effect with trach care. It was noted. I asked about the GPC and c Diff bacteria cultures. They were negative. They still changed his pic line to his left side. Dad rested comfortably most of the night. I actually slept pretty well. His fever was being maintained for the most part. He makes attempts to reposition himself and moves his legs frequently. Mom arrived about 9:30am. A couple of days this past week she has arrived with a Speedway Mountain Dew slushie for me :) She laughed and said she is the only person at Speedway buying MD at that time of the morning! She said normal people drink coffee or cappaccino, yet she is a tea drinker who comes in with a Coke! When I leaned over to tell Dad I was leaving, he puckered his lips and I gave him a smooch. An 'awe' was elicited from the nurses and tech.

I got home after noon, rattled Courtney into gear(no college classes this day), snagged the 1994 Audi instead of the beastly 2004 Expedition, and headed to Grandville. I needed to stop at Calvin to drop of meds and orchestra clothes for Kelsey and Courtney and I had errands at Rivertown Crossings. My hubby had ordered the wrong size of UGG boots at Christmas for the girls so we made a quick check of the stores for available sizes. Big surprise...a $20 price increase...Bah! We headed to the southeast end of town to JW Pepper for violin and piano music for Courtney. She is playing violin dinner music on Thursday night for the MOPS family dinner at church. We ventured to Woodland Mall. She had a nice smelling cologne spritzed on a card so she could share it with me. Did I like it? This audience approved. She will try and buy it online. I picked up a much needed second hard-drive for my iMac. I have about 20,000 or more photos eating up space! Courtney and I got home and took care simple kitchen stuff, like dishes and cooking pasta for supper. Kelsey stayed in Grandville, heading to Christopher's after school until Poms practice, then she shuttled her and fellow dancer, Katie to their orchestra concert at the Godwin Heights High School Auditorium. I arrived during the 7th & 8th grade performance. After hugs and kisses following the concert I was off to the hospital and she headed home. Courtney had gone up to the hospital about 8pm so Grandma could leave a little earlier.

I joined Courtney about 9:15pm. Whenever arriving at the hospital after 9pm, one must park in Emergency in the ramp, check in with security, and make a mile long trek, at least it seems like it, through the back of the hospital and back around to the Fred and Lena Meijer Heart Center. Needless to say we try to park in the main ramp so we can make a quick walk across the bridge and right into the Heart Center. Dad was very alert and trying to talk. I am disappointed and ashamed of myself for NOT learning 'lip reading' long ago. When I was a travel agent a friend of mine had several clients that she 'read lips' with. I didn't follow through with that plan of action. When Nurse Jerri and tech gave Dad his bath I walked Courtney out to her car. There is a security guard on duty at the bridge/parking ramp from 10:45-11:30pm, unless they get a call. Well, last night he got a call to the next floor with 'strange people'. That was rather unsettling, since he locks down the doors. Everyone leaving was saying, "Thank you", as I stood holding the door. "You're Welcome!", but I stood there holding the door open watching my daughter walk to her car, talking with each other on our cell phones, with the anticipation of shutting the door and running to Courtney's car if some 'creepo' came down the stairs to 'enter' the hospital!!! The guard returned as she was pulling out.

I sat and put together a few more puzzle pieces of a community work effort by a few families in the lounge. Nurse Jerri came out and got me to say they were done. She was excited because she was able to give Dad a nice, complete shave. Wow, Mom will hardly recognize him come morning! Thinking he would be tired out from all the moving around that he had been doing, not to mention the repositioning the staff assists with, we thought he would be ready to snooze. Not so! He was agitated and very alert. Wouldn't you be if you woke up with wrist restraints, tubes & wires connected to all parts of your body and UNABLE to talk? His mouth was moving a mile a minute, but I could not understand him. Since his vocal chords are not able to function with the new trach and he is still weak, his lips kind of slur the words. Jerri and I told him to say one word at a time. He resorted to hand motions and a stink eye with a scoul for me! I told him I was sorry and that I loved him. He puckered up for a smooch :{} It was a very unsettling night for different reasons. I feel inferior not being able to communicate with him, rather not understanding his questions. Jerri brought in some word & picture cards to use with him. That didn't go so well. So it went ALL night. His temperature was very good, but did spike to 38.7º-39º in the night. We did try turning the TV on. He settled briefly after some frustrating battles of word play. The normal 6-7:00am ex-ray crew arrived, along with a couple of doctors following them. Nurse Brett and tech Nicolette cleaned him up around 9:00am. I snoozed intermittently from 9:30am until Mom arrived at 10:30am. After talking with the ICU doctor I left Mom with this new battle at about 11am. I headed for a haircut with Zachary at Salon Lark on Ionia Street. A little pampering felt good. Dad was scheduled for an echocardiography about 4pm today.

I am leaving soon for the night shift. Pray for patience, perseverence, and
understanding for all of us.

Sunday, February 8, 2009

Organic Chemistry lessons



I wanted to update yesterday but Dave's laptop and the hospital network were not cooperating. I could have probably utilized one of the hospital computers during Dad's bath last night but chose to take a relaxing walk with my camera around the calming, new, artful structures recently unveiled. If Dad is alert(moving hands and feet, looking around & coughing) I usually interact with him. Otherwise, I try watching an epic episode of 'The Back of My Eyelids' in the recliner chair.

Saturday was prep time when I got home. Since Kelsey had been sick and I leave between 8-9pm for the hospital, I had not checked earlier for the chili recipe from the music department. A trip to Meijer to purchase all the makings for chili was in order. Kelsey had the 4:45pm shift at school so the large roaster of chili to feed 20 went with her. Courtney went swing dancing at GVSU and Dave and I left for a 'date night' with the folks at the CCHS music department soup supper. I savored Chicken Soup for the Soul...you could have labeled it that. Dave had chili. Add a baked potato, salad and a yummy dessert and dinner was complete. I can't say the best part was I didn't have to cook, because I did prep and cook chili. It was nice to enjoy all the rest of the stuff without the work.

Friday night they performed an upper quadrant ultra-sound. Everything looked normal. About 1:00am Saturday, nurse Lillian came in with news that Dad's blood cultures had come back positive with gram positive cocci, http://members.tripod.com/piece_de_resistance/SAARS/bugs/mgpc.htm . Since they don't know if the bacteria is directly in his system or perhaps from a 'bad line', such as his pic line, they started him on an IV of Vancomycin. Nurse Lillian also had to draw more blood to culture so they have a 2nd sample to confirm where the bacteria is living. She is very good with drawing blood. She got a very nice draw from the pic line which is almost impossible for anyone else. She said they had also sent in a culture for C diff, http://aids.about.com/od/otherconditions/a/cdiff.htm . About 3:00am he was making frequent attempts to cough. His breath patterns are always effected with this agitation. He continued to battle a fever 38.9º - 40.2ºC, which is about 103-104ºF. He gets Tylenol every 4 hours for the fever. We wish there was something more effective. The broken trach made him 'bubble' (sounds like bubbles being blown through one of those bubble pipes) and caused more phlegm, requiring more frequent suctioning and coughs with the ingenius respiratory suction catheter.

Nurse April was frustrated with his feeding tube. She went through 5 bags and tubes trying to re-connect it after the ultra sound, without success. He received dialysis in the afternoon. Nurse John was ecstatic they were able to remove 3 liters of fluid through dialysis! The best treatment yet. Nurse Lillian was successful at connecting his feeding tube back up. She said they have had numerous problems hospital wide with the tubes. Dad was very alert when I arrived shortly after his dialysis treatment. Nurse Lillian said he had been lethargic most of the day. As mom and I were talking and she was kissing him good-bye I told her Dad had a healthy grip on my hand. I stayed close to his side most of the night talking with him. He continued to have a fever and 'bubble'.

Mom arrived about 8:15am this morning so I could get to church at 9:00am. Dave and I were going to visit after church, but Mom called to say they had taken Dad down to surgery to put a new pic line in on the left side. His temp was down to 38.5)C before that procedure. It went very well. This evening, Dr. Foster performed surgery to replace the defective trach device. He inserted a longer and larger trach device than was previously used. They told Mom that there have been 3 defective trachs just this week! A pharmacuetical rep will be coming this week to the hospital regarding the defective trach devices and feeding tubes. I am leaving soon to relieve mom.

Friday, February 6, 2009

Trial and Error of a Tracheotomy



We had a safe trip to and from Auburn Hills. Kelsey and Christopher enjoyed the game, despite Miami Heat losing by 3 points. During the game, Kelsey's lips swelled and her face became increasingly red with hives. The ride home was uncomfortable for her. By morning the red blotches all over her body had blended to look like a ripening tomato. Her feet looked like she had walked through hot coals. I called after hours care first thing in the morning and they scheduled her for a 10:15am appointment with her doctor. Due to Showcase at Calvin Christian, the school day ended at 1pm on Thursday, so she missed another day :( Her pulse was at 156, which is high. They asked if she felt like her heart was racing. Dr. Halverson detected a heart murmur, but after a few minutes said it was probably from the congestion. Kelsey had extensive breathing tests done about 2 months ago and nothing significant was detected at that time. She said they will monitor any changes. We think she had a reaction to Diphahydramine. Unfortunately, I did not look at the active ingredients close enough when I gave her Tylenol Night time. We know she breaks out in hives from Benadryl, which is the same thing! I'm usually very good about cross referencing any meds on the computer before I give them to her. Dr. Halverson ordered Prednisone for the hives and Phenergen w/codeine for her cough. She slept the day away.

Mom checked in with me to see how Kelsey was doing. I checked in with Mom to see how Dad was doing. They had come in at 8:45pm Wednesday to do the CT Scan. Dad continues to have a fever, hovering around 101º. They work with celsius so it is in the 38ºC + points range. I relieved mom at 9pm Thursday night. She had been holding ground for 33 hours. My cousin Jim had stayed with Murphy on Wednesday night. Needless to say, when Mom arrived home Thursday night Murphy was elated!

When I arrived, Nurse John was completing dialysis. Dad had clotted a couple of times creating a more difficult path. They have been unable to remove extra fluids through the dialysis. It is very frustrating. Nurse John explained that is the unfortunate side effect of 40 years of smoking, despite his quitting 10 years ago! His heart and lungs can't keep pace with the machine. It also happens to people with asthma. Dad is so swollen. It makes it really difficult to draw blood which they usually need to do a couple of times a day. The doctors said he should be able to gradually release fluids with stool activity. He must have heard the doctors talking about ordering a suppository...lol. Hopefully all those toxins and infection will pass. I was also brought up to speed that the trach that had been inserted Thursday morning was broken. The respiratory team had managed to repair it with a rubberband! Another respiratory tech came in and looked at it and said it was the second one he had seen that had broken. Apparently it is defective. One surgeon came in last night and decided as long as it was working and not causing stress they would leave it until Friday when a complete team could be assembled to replace it. An associate of Dr. Foster came in this morning to check on it. She looked younger than our 19 year old! The nurse and I both did a double take when she introduced herself as a surgeon! She explained that it is best if they can leave a new trach in for 5-7 days before moving it so the pathway has time to heal. Dr. Foster had already advised the nurse he wanted it replaced and would not be available until late afternoon. I guess they will replace it later today. I was unsettled for most of the night. He has an infection somewhere. They don't know yet. Dad's blood pressure was up, he was swollen, his fever continued and he was congested. Due to the broken trach they had to be more careful moving him, which they like to do every couple of hours so the skin doesn't break down. Every time they moved him or checked him they would have issues with the trach. It was oozing more due to the break, plus the rubberbands would come off. He would be agitated and his blood pressure and fever would go up. This morning the respiratory team turned off the vent again. He still has lots of congestion and 'gunk' in his lungs. For the most part his breathing is fairly good. His room is rather chilly due to the staff trying to bring his fever down. I wear a fleece hoody with the hood on and keep a down blanket nearby. Mom says she keeps her scarf on often draping her winter coat over her shoulders. Welcome to the Spectrum Health cooler!

Kelsey called at lunch time from school with a pounding headache and a return of hives. I left and retrieved a red and swollen daughter from 5th hour Global Studies. We will have to make arrangements later to retrieve her car. Thanks to leftovers from the Poms Team dinner we hosted on Tuesday, I have had a base to feed my family fairly conveniently this week. All I need now is to find time to get a much needed haircut.

The Lord himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged.
Deuteronomy 31:8 NIV

Wednesday, February 4, 2009

Extubation grade: F

I didn't get to the hospital until a little after 10pm last night to relieve mom. Dad had a fairly quiet night, nothing out of the ordinary. The nurses & techs turn & check. He spiked a fever of about 101º last evening so they had ice packs on him. They don't know the cause of the fever, but don't suspect pneumonia since his lungs sound good. They had ice-pack around him and under his neck. Ex-ray was in at 6am and they had a team in for blood draw :) They have a hard time drawing blood even out of his pic line. One tech was checking out his feet for a spot...OUCH, but then the other tech found a good draw on his left hand between his thumb and index finger.

Dr. Koets was in with an associate, along with the respiratory tech. After Mom arrived they extubated(took the breathing tube out). Unfortunately, Dad struggled and gasped for breaths and could not get his breaths under control by himself. They re-intubated and ordered a trach, which a general surgeon will perform in his room. As Dr. Koets put it, "He flunked the test." :( His vocal chords are stressed and swollen from the irritation of the vent. They will better be able to allow him to wake up to get a better evaluation with the trach. It usually takes a couple of days after its ordered to get in place. The surgeon called and it will be done at 8am tomorrow! Nurse Val was astonished at how quickly it will happen. When I left he was not as warm and his body was cooling down, although his face and neck were still warm to the touch. Mom is staying the night with him. I will try to update again tomorrow. They did an ultra sound of his legs to rule out blood clots and will perform a CT Scan of his head later today.

Courtney is riding along with me as I am driving Kelsey and Christopher to a Detroit Pistons/Miami Heat game at The Palace in Auburn Hills tonight. Dave said its way past his bedtime to be out...lol. He was willing to go along if Courtney didn't want to go. It wasn't the most opportune time but the doctors said Dad should rest quietly all night, so I feel a little reassured about being 2 1/2 hours away for the evening. A friend of Kelsey and Courtney's was able to get 2 front row tickets to the game...for FREE. It should be a good time for them. I will try to keep my patience under control. I will check in with Mom during the night.

In HIM above do we lay our trust. Before he went in for surgery, Dad said the good Lord laid out the game plan for him and he is willing to do the work to achieve the goal. He said he has come too far an d played the game too long to give up now. Pray for answers to the fever and that he will be able to wake up and control his breathing on his own.

Watching toe wiggles in the ICU

This is our 6th night in ICU at the Fred & Lena Meijer Heart Center. Dad is still on the vent, but is mostly breathing on his own. They suction out his lungs and mouth & help him 'cough'. I'm amazed at the ingenuity that someone had to invent this gadget, not to mention all of the machines that keep the staff informed of what is happening in his world. He has had a feeding tube for 2 full days, thus the tube removing bile from his stomach was removed. I think they have done ex-rays of his head or chest everyday. The EEG equipment is now gone. He no longer looks like a mad scientist with a gauze beanie! He has a blood pressure cuff connected all the time with a monitor above his bed. He has a pic line to deliver his meds because his veins are near non-existent to find. He is a pin cushion with the blood thinner as it is. Dad gets his belly poked so many times, its a wonder he doesn't spring a leak. The leg cuffs inflate & deflate circulating his blood. He even has an 'air' bed, although it sounds really creepy when it inflates/deflates. It reminds you of a gas line being turned on! The spinal tap revealed NO infection, the MRI & CT Scan showed no signs of stroke or tumors...yay! The doctors are confident that the seizure was caused from the hormonal imbalance from removing the kidney. His blood pressure continues to fluctuate all over the board. The neuro specialist has not seen any seizure activity with the increased anti-seizure meds. They tried waking him up earlier, but he was cringing like he was in pain so they dosed him with pain meds. He does open his eyes but is not consistent with following our voice. He also can squeeze our hands but not always consistent on demand. He WIGGLES his TOES, pulls his arms & legs up, thus requiring comfy wristlets & straps to keep his hands from pulling out any crucial tubing. He has just enough give that he can almost reach tubes & wires. We talk directly to him frequently, looking for signs of fighting through the sedation. We take it one day at a time, praying that when he does wake up he will have his sight back and will not endure anymore seizures.

Kelsey is back in school from her bronchitis/head cold. Courtney & I are both fighting off sneezes. Thank goodness for anti-bac in the hospital. I think its full of germs! Somehow Dave has managed to keep all the sickness away. We hosted the Poms Team for dinner tonight before the Calvin Christian boys bb game against Covenant Christian. The girls enjoyed a croissant roll taco ring, beef & chicken fajitas, salad, chips & salsa, and sugar cookie & ice cream sandwiches. Yes, we have leftovers. The Poms Team dance routine was very hip & they performed it well. Calvin won by 3 pts.

I'm sitting in the not so 'comfy' recliner in Dad's room & its shouting to recline. I'll be here until about 11am when Mom arrives. She has a long day tomorrow, with plans to take my night shift. I am planning to drive Kelsey & a friend to Auburn Hills after school & back home after a game. More on that probably on Thursday.